What is smallpox?

Smallpox is an acute contagious disease caused by variola virus, a member of the orthopoxvirus family.

Smallpox, which is believed to have originated over 3,000 years ago in India or Egypt, is one of the most devastating diseases known to humanity. For centuries, repeated epidemics swept across continents, decimating populations and changing the course of history.

In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive.

Smallpox killed Queen Mary II of England, Emperor Joseph I of Austria, King Luis I of Spain, Tsar Peter II of Russia, Queen Ulrika Elenora of Sweden, and King Louis XV of France.

The disease, for which no effective treatment was ever developed, killed as many as 30% of those infected. Between 65–80% of survivors were marked with deep pitted scars (pockmarks), most prominent on the face.

Blindness was another complication. In 18th century Europe, a third of all reported cases of blindness was due to smallpox. In a survey conducted in Viet Nam in 1898, 95% of adolescent children were pockmarked and nine-tenths of all blindness was ascribed to smallpox.

As late as the 18th century, smallpox killed every 10th child born in Sweden and France. During the same century, every 7th child born in Russia died from smallpox.

Edward Jenner’s demonstration, in 1798, that inoculation with cowpox could protect against smallpox brought the first hope that the disease could be controlled.

In the early 1950s – 150 years after the introduction of vaccination – an estimated 50 million cases of smallpox occurred in the world each year, a figure which fell to around 10–15 million by 1967 because of vaccination.

In 1967, when WHO launched an intensified plan to eradicate smallpox, the “ancient scourge” threatened 60% of the world’s population, killed every fourth victim, scarred or blinded most survivors, and eluded any form of treatment.

Through the success of the global eradication campaign, smallpox was finally pushed back to the horn of Africa and then to a single last natural case, which occurred in Somalia in 1977. A fatal laboratory-acquired case occurred in the United Kingdom in 1978. The global eradication of smallpox was certified, based on intense verification activities in countries, by a commission of eminent scientists in December 1979 and subsequently endorsed by the World Health Assembly in 1980.

Smallpox still exists in laboratories. In 2011, the BBC reported that a decision on when to destroy the last known stocks of live smallpox virus had been put off for another three years. The WHO agreed to resume the discussion in 2014.

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One thought on “What is smallpox?”

In 1949 my grandmother worked at a hospital where there was an outbreak of Smallpox. It as a small outbreak compared to this one, but a few people died. It was also the last natural outbreak of smallpox in the US.

I didn’t really know that she had witnessed smallpox until a few months ago. I remember when I was young, I asked her if she had ever encountered smallpox during her life (I was interested in the subject at the time). Since she was born in 1912, I thought maybe it was a possibility. Her response was odd. She got very quiet and told me that it was terrible disease” and that it “smelled awful”. I had no idea what that really meant and I never asked anything further (not that she would have answered). Anyway, I found information on the Texas outbreak recently and it made me realise she was working in that hospital during that time. So was my grandfather.

It really was strange. She would talk openly about Spanish Influenza if I asked, but she wouldn’t discuss smallpox at all. Whatever she saw really disturbed her.